Aiding Ailing Hearts

South Africa's adventurous surgeon Christiaan Barnard startled the scientific world late last year by announcing that he had not only given a patient a new heart but had left most of the old one, still beating, in place (TIME, Dec. 9). Although the world's first twin-heart patient, an engineer named Ivan Taylor, died early in April, Barnard is still satisfied that his surgical spectacular was a success. The death, he explained last week, was not directly related to the operation. Taylor died not because his body rejected the new heart but as a result of a blood clot in his lung. Up to the time of his death, his two hearts were still pumping properly.

Barnard noted that Leonard Goss, 47, a Cape Town railway worker who received a second heart early this year, is back at work and doing well. At least four others share Barnard's confidence. They are planning to have the same operation as soon as suitable donors can be found.

Intricate Installation. Another ingenious technique for treating patients with ailing hearts has been developed by surgeons in New Orleans. Doctors had assumed that Suzette Marie Creppel, 17, would eventually have to undergo open-heart surgery to correct an atrial septal defect--a hole in the wall separating the two upper chambers of her heart. But Drs. Terry King and Noel Mills of the Ochsner Foundation Hospital decided to try to plug the leak with two tiny, round patches--and without surgery.

They made two circular patches only 11/2 inches in diameter, folded them like umbrellas and fitted them into a capsule less than a quarter of an inch in diameter. The capsule was attached to the end of a catheter inside a catheter, which was inserted into a large vein in Suzette Marie's right thigh and worked through a pathway of veins into the heart (see diagram). The doctors then pushed the capsule and outer catheter first into the right atrium and finally into the left atrium, extended the first umbrella and pulled it back against the edges of the opening. Then they drew the catheters back through the hole into the right atrium, opened the second umbrella, locked it to the first and sealed off the hole. Suzette Marie is making a speedy recovery.

King and Mills warn that the 90-minute procedure, which cannot be used in all cases of septal defects, must pass the test of time. But where the umbrella technique is appropriate, they hope it will lessen the complications--and cut the costs--for patients who would otherwise have to undergo open-heart surgery.

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